Abstract

BackgroundMild cognitive impairment (MCI) represents a critical window to intervene against dementia. Exercise training is a promising intervention strategy, but the efficiency (i.e., relationship of costs and consequences) of such types of training remains unknown. Thus, we estimated the incremental cost-effectiveness of resistance training or aerobic training compared with balance and tone exercises in terms of changes in executive cognitive function among senior women with probable MCI.MethodsEconomic evaluation conducted concurrently with a six-month three arm randomized controlled trial including eighty-six community dwelling women aged 70 to 80 years living in Vancouver, Canada. Participants received twice-weekly resistance training (n = 28), twice weekly aerobic training (n = 30) or twice-weekly balance and tone (control group) classes (n = 28) for 6 months. The primary outcome measure of the Exercise for Cognition and Everyday Living (EXCEL) study assessed executive cognitive function, a test of selective attention and conflict resolution (i.e., Stroop Test). We collected healthcare resource utilization costs over six months.ResultsBased on the bootstrapped estimates from our base case analysis, we found that both the aerobic training and resistance training interventions were less costly than twice weekly balance and tone classes. Compared with the balance and tone group, the resistance-training group had significantly improved performance on the Stroop Test (p = 0.04).ConclusionsResistance training and aerobic training result in health care cost saving and are more effective than balance and tone classes after only 6 months of intervention. Resistance training is a promising strategy to alter the trajectory of cognitive decline in seniors with MCI.Trial RegistrationClinicalTrials.gov NCT00958867.

Highlights

  • Cognitive decline is one of the most prominent health care issues of the 21st century

  • We previously demonstrated that two doses, once or twice weekly resistance training compared with balance and tone classes significantly reduce health care resource utilization among older adults [24]

  • Cost Effectiveness Analysis Based on the bootstrapped estimates from the cost-effectiveness plane (Figures 1 and 2) of our base case analysis we found that aerobic training (AT) and resistance training (RT) were less costly and more effective than balance and tone classes (BAT)

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Summary

Introduction

Cognitive decline is one of the most prominent health care issues of the 21st century. The number of people affected is projected to be over 80 million by 2040 [1]. Given the ageing population and the number of individuals affected by cognitive decline, the societal value of cost-effective intervention strategies is critically important in an environment where health care resources are scarce and finite [3]. Exercise training is a promising intervention strategy, but the efficiency (i.e., relationship of costs and consequences) of such types of training remains unknown.

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